I’ve written a lot (here, here, and here, for example) about cardiac pain, because I live with a lot of cardiac pain called refractory angina due to a pesky post-heart attack diagnosis of coronary microvascular disease. This pain varies, but it hits almost every day, sometimes several episodes per day, and it can feel very much like the symptoms I experienced while busy surviving what doctors call the widow maker heart attack in 2008.
But there’s pain, and then there’s suffering. The two are not the same.
I spent many years working in the field of hospice palliative care, where we all learned the legendary Dame Cicely Saunders‘ definition of what she called “total pain”.(1) This is the suffering that encompasses ALL of a person’s physical, psychological, social, spiritual, and practical struggles. Although addressing total pain is an accepted component of providing good end-of-life care for the dying, the concept seems to be often ignored in cardiac care for the living. Continue reading “Pain vs. suffering: why they’re not the same for patients”→
Dr. Martha Gulati is an internationally recognized expert on women’s heart disease. She’s Professor of Medicine and Chief of Cardiology at The University of Arizona in Phoenix, where she is creating a centre specifically for Women’s Cardiovascular Health. The best-selling co-author with Sherry Torkos of the book, Saving Women’s Hearts, Dr. Martha is also the Editor-in-Chief of the American College of Cardiology’s CardioSmart, a Scientific Advisory Board member of WomenHeart: The National Coalition for Women with Heart Disease, and a board member of the American Society of Preventive Cardiology, the Phoenix American Heart Association and other notable organizations.
She is, in short, one of the rock stars of women’s cardiology.
When California sociologist Dr. Kathy Charmaz studied the subject of suffering among those living with chronic illness, she identified an element of suffering that is often overlooked by health care providers.(1) As she explained her findings:
“A fundamental form of that suffering is the loss of self in chronically ill persons who observe their former self-images crumbling away without the simultaneous development of equally valued new ones.
“The experiences and meanings upon which these ill persons had built former positive self-images are no longer available to them.”
When I was about eight months pregnant with Ben, my first baby, I was diagnosed with something called preeclampsia. This is a serious condition affecting about 5% of pregnant women, identified by symptoms like sudden spikes in blood pressure, protein in the urine, severe swelling and headaches or vision problems. It’s also women’s third leading pregnancy-related cause of death. Preeclampsia is clinically described as:
“…a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks’ gestation”.
Whenever you see the words “vascular” or “endothelial” or “vasospasm” in the same sentence, you know you’re likely talking about the heart. And although preeclampsia typically goes away after pregnancy, its diagnosis may well be an early indicator of underlying heart conditions that may simmer for decades. In fact, studies now show that pregnant women who develop preeclampsia have more than twice the risk of having a heart attack or stroke later in life.
In the astute words of the late Irish soccer star, George Best:
“People say you have to hit rock bottom, and I can tell you that almost dying is as rock bottom as it gets.”
Here at Heart Sisters World Headquarters, we have important news from the Department of the Bleedin’ Obvious: feeling terrified by the immediate possibility that you’re dying is “quite common among patients suffering a heart attack”, according to U.K. research published in the European Heart Journal.(1)
In fact, researchers observed that “although heart attack survival rates have improved tremendously over the last few decades, many patients remain quite frightened during the experience” (an understatement, by the way, that could only have been uttered by somebody who’s never actually experienced a frickety-frackin’ heart attack).
But it turns out that the intense distress caused by this fear of dying in mid-heart attack is not only a common emotional response, but is also linked to actual biological changes during the weeks following a cardiac event – changes that are ironically associated with a higher risk of suffering yet another heart attack.